little more complicated and may develop symptoms months after the initial trauma.
An avulsed tooth is one that is knocked completely out of the socket. First aid centers on care for the tooth and timeliness. Many avulsed teeth can be reimplanted successfully when not too much time passes. If you can find the tooth, pick it up by the crown, the portion you normally see in your mouth. Place the tooth into a clean glass of milk or water to retain its moisture. Your patient should get to a dentist or emergency room within 1 hour for the most success.
Fractured teeth are often the result of some type of
trauma. A fractured tooth is much like a broken china cup. The break lines are not clean and tidy, there are usually microscopic pieces missing. Therefore, it is not necessary to retain the fractured portion. Pain, swelling and sensitivity to hot and cold are the most common symptoms of a fractured tooth.
You may treat the pain with analgesics and cold compresses. A dentist will need to restore the patient’s tooth with dental materials.
Trauma to a tooth is much like trauma to any other body part. The teeth may actually turn dark or bluish as a result of the injury, similar to a bruise. The bruising may go away and the tooth may be fine, or further treatment may be needed. Any dental injury should be evaluated by a dentist as soon as possible to acquire baseline information and perform necessary treatment. Emergency medical care is usually not needed, but your PIC should be notified.
OPEN ABDOMINAL INJURIES
Although open abdominal injuries are extremely rare, you may one day encounter an injury that has allowed abdominal organs to protrude through the skin. After you control any bleeding that is present, your next priority is to protect the abdominal cavity and exposed organs. Never attempt to push the organs back in. Cover them with a wet, sterile dressing and tape the dressings gently in place.
The risk for infection and shock in this patient is extremely high, so any delay in notifying the PIC and calling Aircare Access may put the patient in a life- threatening situation. This type of injury is particularly frightening to the patient, as well as by- standers. Continually reassure the patient, watch for changes in level of consciousness and monitor the CABs. If oxygen is available, deliver it at high flow.
72 Trauma
BURNS
Burns can be one of the most painful types of injuries. Onboard, burns may be limited to hot water or electricity, but when on the ground, you may experience other types of burns. With any serious burn onboard, notify your PIC, contact Aircare Access and treat the burns as necessary.
THERMAL BURNS
A burn is a type of skin injury. Although most burns are minor, some require hospitalization. Severe burns may also be life-threatening. The covering of your body, the skin, is comprised of 3 layers. The epidermis is the outermost layer, the dermis is the middle layer and the subcutaneous tissue is the deepest.
The depth and severity of a burn can vary, affecting some or all of the layers of the skin. The depth of a burn is used to classify the injury as a first, second or third degree. Symptoms vary depending on a burn’s severity; however, common signs and symptoms include pain, blisters, redness and swelling. Severe burns may cause the skin to appear white or charred.
According to the American Burn Association, there are more than 1 million burn injuries each year in the U.S., most of which are preventable. Burns are caused by exposure to thermal (steam, flames), electrical (lightning strike, open wiring), chemical (lye, sulfuric acid) or radioactive (ultraviolet radiation, x-rays) agents.
More severe burns require emergency medical attention to prevent shock, infection, scarring and a number of other possible complications. People with third degree burns often require skin grafting, surgery and pain medications.
The majority of burns are caused by scalds, building fires, flammable liquids and gases. There are many steps a person can take to reduce the risk of getting a burn; setting the home water heater temperature to 120 degrees or less, testing the water temperature before stepping into a shower or bath and having fire extinguishers handy.
Burns of any size, shape or degree are very painful. Even first degree burns can be potentially life- threatening due to excess fluid loss and the potential for infection. Our skin acts as a barrier which keeps out organisms and disease while allowing the body to remain hydrated. When this barrier is damaged, especially a large area, the potential for more problems increases.
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